Boston, MA -- Heavy alcohol use, or binge drinking, among college students in the United States is tied to conditions in the college environment. That is one of the key findings from research conducted by researchers with the Harvard School of Public Health College Alcohol Study (CAS), a landmark study that surveyed more than 50,000 students at 120 colleges from 1993 to 2001. In a new review that examines the findings from the CAS and their implications, the researchers conclude that heavy drinking behavior of students was more common in college environments that have a strong drinking culture, few alcohol control policies on campus or in the surrounding community, weak enforcement of existing policies, and alcohol made easily accessible through low prices, heavy marketing and special promotions. The review appears in the July 2008 issue of the Journal of Studies on Alcohol and Drugs.

The review was conducted by CAS Director Henry Wechsler, lecturer on society, human development and health at Harvard School of Public Health and Assistant Director Toben Nelson, assistant professor of epidemiology and community health at the University of Minnesota.

During its 14-year existence, the CAS focused attention on widespread binge drinking at American colleges and the ensuing serious health and social consequences to drinkers, fellow students and neighbors. "Our study drew attention to the heavy drinking of students, most of whom were not considered alcoholics or in need of traditional treatment, but nevertheless experienced problems as a result of their drinking," said Wechsler. Students who binge drink--defined by the CAS as five or more drinks in a row for males, and four or more drinks for females, on a single occasion in the past two weeks--are more likely to experience a wide range of problems, including academic difficulties, social conflict, risky sexual behavior, risky driving behavior, vandalism, injury and alcohol overdose. Binge drinkers were also more likely to engage in other risk behaviors such as tobacco and illicit drug use. Students who binge drink frequently were most likely to experience these problems.

In addition to the harms drinkers cause for themselves, CAS research drew attention to the problems that drinkers cause for others on and around campus. The "secondhand" effects of alcohol use, similar to the concept of secondhand smoke, helped people understand that student drinking is harmful to the larger campus community. These problems include drinking-related behavior that is disruptive to studying and sleep, vandalism, and physical and sexual assaults.

"The five/four drink binge measure is a good indicator of who will experience alcohol-related problems, and more importantly, captures most students who actually experience problems, something measures with higher drink thresholds fail to do," said Wechsler. Binge drinkers account for the vast majority of unintentional injuries, vandalism and disorderly behavior on campus due to alcohol, the researchers found.

CAS research focused on the contribution of the college environment to student drinking behavior. "Binge drinking among college students varies widely from college to college," said Nelson. "At some colleges almost no students binge drink, while at others nearly four in every five students do. Interestingly, we found that the levels of binge drinking, and the problems related to it, remain very stable at the same colleges over time." This finding occurred despite surveying a new group of students in each of the CAS surveys. "That suggests there is something about certain college environments that promote binge drinking," added Nelson.

While some students chose to enroll in a college because it has a party reputation, CAS research found that campuses that emphasize intercollegiate athletics and fraternity and sorority life have higher levels of binge drinking. Students who lived off-campus with friends or in other unsupervised settings were also more likely to binge drink.

On the other hand, colleges that restricted use by banning alcohol on campus or offering substance-free housing options had fewer drinkers, and as a result lower binge drinking levels. State and local government can also play a role. Students who attended colleges in states with stronger alcohol control policies were less likely to be binge drinkers.

The ease with which students can access alcohol is another important factor. "A 'wet' college environment, one that has many stores where students can buy alcohol, and may be influenced to do so by heavy marketing, low prices and special promotions, creates the conditions for heavy drinking," said Wechsler. "If colleges can change those conditions, they can reduce binge drinking among their students."

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"What We Have Learned From the Harvard School of Public Health College Alcohol Study: Focusing Attention on College Student Alcohol Consumption and the Environmental Conditions That Promote It," Henry Wechsler, Toben F. Nelson, Journal of Studies on Alcohol and Drugs, 69(4):481-490, 2008.

The Harvard School of Public Health College Alcohol Study was funded by grants from the Robert Wood Johnson Foundation.

Harvard School of Public Health (www.hsph.harvard.edu) is dedicated to advancing the public's health through learning, discovery, and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children's health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit: www.hsph.harvard.edu

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